| Rurban Health | |
|
605 S Olive Ave Sandpoint ID 83864-1154 | |
| (208) 899-9312 | |
| Not Available |
| Full Name | Rurban Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 605 S Olive Ave, Sandpoint, Idaho |
| Authorized Official Name and Position | Rio Petersono Peterson (FOUNDER/ CEO) |
| Authorized Official Contact | 2086868060 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rurban Health 605 S Olive Ave Sandpoint ID 83864-1154 Ph: (208) 899-9312 | Rurban Health 605 S Olive Ave Sandpoint ID 83864-1154 Ph: (208) 899-9312 |
| NPI Number | 1205556859 |
|---|---|
| Provider Enumeration Date | 09/01/2022 |
| Last Update Date | 12/22/2022 |
| Certification Date | 12/22/2022 |
| Medicare PECOS PAC ID | 7416321039 |
|---|---|
| Medicare Enrollment ID | O20230322002564 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205556859 | NPI | - | NPPES |
| Provider Name | Tawni L Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508226226 PECOS PAC ID: 9335421114 Enrollment ID: I20170131002781 |
| Provider Name | Rio Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841966819 PECOS PAC ID: 6204210891 Enrollment ID: I20230323001336 |
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